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Malignant hyperthermia (MH) is a type of severe reaction that occurs in response to particular medications used during general anesthesia, among those who are susceptible. [1] Symptoms include muscle rigidity, fever, and a fast heart rate. [1] Complications can include muscle breakdown and high blood potassium.
Dantrolene was widely used in the management of spasticity [19] before its efficacy in treating malignant hyperthermia was discovered by South African anesthesiologist Gaisford Harrison and reported in a landmark 1975 article published in the British Journal of Anaesthesia. [20]
Hyperthermia therapy (or hyperthermia, or thermotherapy) is a type of medical treatment in which body tissue is exposed to temperatures above body temperature, in the region of 40–45 °C (104–113 °F). Hyperthermia is usually applied as an adjuvant to radiotherapy or chemotherapy, to which it works as a sensitizer, in an effort to treat cancer.
Recreational drugs such as amphetamines [17] and cocaine, [18] PCP, dextromethorphan, LSD, and MDMA may cause hyperthermia. [2] Malignant hyperthermia is a rare reaction to common anesthetic agents (such as halothane) or the paralytic agent succinylcholine. Those who have this reaction, which is potentially fatal, have a genetic predisposition. [2]
When used in a vein, onset of action is generally within one minute and effects last for up to 10 minutes. [7] Common side effects include low blood pressure, increased saliva production, muscle pain, and rash. [7] Serious side effects include malignant hyperthermia, hyperkalemia and allergic reactions.
Serious side effects can include malignant hyperthermia or high blood potassium. [4] It should not be used in patients with a history of malignant hyperthermia in either themselves or their family members. [3] It is unknown if its use during pregnancy is safe for the fetus, but use during a cesarean section appears to be safe.
The hydantoin derivative dantrolene is used as a muscle relaxant to treat malignant hyperthermia, neuroleptic malignant syndrome, spasticity, and ecstasy intoxication. Ropitoin is an example of an antiarrhythmic hydantoin.
Use is only recommended with direct medical supervision. [5] Common side effects include anxiety, headache, sleepiness, cough, and nausea. [5] Serious side effects may include kidney problems, liver problems, low blood pressure, and malignant hyperthermia. [5] [4] It is unclear if it is safe in either pregnancy or breastfeeding. [5]